The clinical training focuses on establishing clinical competence in cardiovascular MRI and cardiovascular CT. Fellows participate in the primary acquisition and interpretation of over 500 cardiovascular MRI and over 400 cardiovascular CT clinical examinations during a standard 2 year fellowship which fulfills Level 3 competence for Advanced Training in both cardiovascular CT and MR as outlined in Task Force 12 COCATS2 Guidelines. Our program performs over 1200 cardiovascular MRI and approximately 600 contrast enhanced cardiovascular CT exams per year. Between 1999 and 2011, approximately 32 clinicians have rotated through the Advanced Cardiovascular Imaging Fellowship program. Initially, clinical training only involved cardiovascular MRI. Since 2009, the fellowship has expanded to include cardiovascular CT. The majority of trainees have been cardiologists but two were radiologists. While the majority of clinical fellows were completely funded by NHLBI, 10 had a significant portion of their training supported by other programs including Johns Hopkins University and Childrens National Medical Center. Of the 46 fellows that have come through the Advanced Cardiac Imaging Program between 1999 and 2015, about 8 past fellows can be considered leaders in the field. Of the 8 fellows that went into private practice, at least three use cardiovascular MRI in their practice.